Residents who are constantly on the call bell... help!

Specialties Geriatric

Published

We have a resident or two (mostly one major offender) who is ALWAYS on her call bell.... seriously, it can be as often as every 5-10minutes when she is at her peak. It is not uncommon to leave her room, and have her bell go off as you exit the doorway. I just dont know what to do to appease her! The CNA's are exhausted, and hate to be assigned to her more than 1 day in a row. Usually it is just little requests... handing her something that is hardly out of reach, rolling up the bed a half inch, refilling a 3/4 full beverage. Every time I assist her, I make sure to ask "is there anything else I can help you with?" before leaving the room, and she'll say "no", but is back on the light a minute later. These are not new behaviors for her, she has been like this since before I started working there. What can we do? (wanted to add that she has her beside table SO full of stuff, but she still asks us to hand her the items that are right in front of her. There is no room to move anything closer!)

Once we tried to document all the requests, but it filled pages and pages and gave us a terrible hand cramp. Help me!

Specializes in ER, Trauma.

I'd press her primary for a psych consult before the staff all need one. She's screaming for some kind of help she's not getting. Her quality of life might improve dramatically with something as simple as xanax.

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At my old LTC (this was in the old days) this is what they did with the PIA patients. If one of the PIA patients got hospitalized for any reason they would fill the person's bed with a new admit right away. Then when the hospital would call saying we are now sending your PIA patient back they would refuse to admit them stating "Sorry, his bed got filled and he can't come back. We are all filled up-no vacancies. They would say that even if there were vacancies available.

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Thanks for the advice, friends!!

Unfortunately, this resident currently gets a host of psych meds, and we've filled the backs of 3 January PRN MAR's just charting all her PRN use (and goodness, we have tried to schedule as much of her meds as possible, but the MD refuses more- with good reason!)

I have noticed when she is up and going to therapy, she is better... but trying to bring her out the nurses station is a nightmare, because once again she will randomly call "hello??" since there is no call bell, then kvetch about not being in her room. Doh!!!

Okay, need to get ready for work now.... glad I am not the only nurse out there with a patient like this!

(oh, and she once went out for surgery/rehab for a month and the family paid to hold her room.... money talks in LTC :mad:)

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Specializes in Peds Medical Floor.

You gotta grow a thicker skin (I mean that with love:redpinkhe). If there aren't activities or something going on and she has to sit by the nursing station, when she keeps yelling hello! answer her the first time. Then firmly but kindly say, "I'm sorry I am busy right now and will talk to you when I'm finished *charting* *passing meds*, etc. Then try to catch her when she's not being annoying. Thank her for her patience and try to talk to her then. Rewarding the good behavior and ignoring the bad behavior usually works for me (when it's someone who is with it). Good luck!!!!

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I agree with the above. She needs copmpany and something to do. You never take a call bell away, unless she had another way to call for help. Legal issues galore!

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Specializes in Gerontology, Med surg, Home Health.
At my old LTC (this was in the old days) this is what they did with the PIA patients. If one of the PIA patients got hospitalized for any reason they would fill the person's bed with a new admit right away. Then when the hospital would call saying we are now sending your PIA patient back they would refuse to admit them stating "Sorry, his bed got filled and he can't come back. We are all filled up-no vacancies. They would say that even if there were vacancies available.

If we did that in Massachusetts, the DPH would be out in a flash reading us the riot act. I agree with getting her involved in activities or at least sitting her in the hallway. You can't ignore her call bell. One of these times, it really will be important and all y'all will have to deal with the consequences.

PS. Call your ombudsman and ask for his/her assistance in dealing with this person. You might not solve the problem but at least it shows you're trying.

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Specializes in LTC, Hospice, Case Management.

Does humor work with this resident at all? We had a recent new admit just like you describe. I was working the floor & after my 10th trip in to the room in an hour & finally laughed & said something to the effect "You're going to get me fired if you don't give me time to take care of the rest of my patients. If I get fired who's going to take care of you with a smile on their face". I said this to her in a happy voice with a smile on my face & it did work for a bit.

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Yeah, there is something called a bed hold policy that all facilities must have.

I agree with the above...suggestions. After all needs are met,you need to "ignore" then calling out. What about activities? Family or friends visiting? Make her do what she can do for herself. Make sure everything is careplanned to and of course the documentation. If it might become a bigger issue (family saying you neglect her) make sure you get the ombudsman involved.

I think we all have had one or two of these types before....sometimes more than one at once.

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Specializes in LTC.

I think we all have had one or two of these types before....sometimes more than one at once.

We have one room.. that is ALWAYS. on the call light. Since my first day there.. to now.. that room.. no matter who is in it. is always on the call light. every shift... at least once per half hour. and the CNA is always going there.

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Specializes in MDS/Office.
Thanks for the advice, friends!!

Unfortunately, this resident currently gets a host of psych meds, and we've filled the backs of 3 January PRN MAR's just charting all her PRN use (and goodness, we have tried to schedule as much of her meds as possible, but the MD refuses more- with good reason!)

I have noticed when she is up and going to therapy, she is better... but trying to bring her out the nurses station is a nightmare, because once again she will randomly call "hello??" since there is no call bell, then kvetch about not being in her room. Doh!!!

Okay, need to get ready for work now.... glad I am not the only nurse out there with a patient like this!

(oh, and she once went out for surgery/rehab for a month and the family paid to hold her room.... money talks in LTC :mad:)

So you say she's already on a host of psych meds, well maybe she needs an adjustment in those meds.....

or maybe she needs an Inpatient stay to a psych unit for awhile.

Maybe the DON/Administrator need to get involved with this.

It's Residents like this that burn out staff & contribute to high turnover..... :twocents:

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Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

Bingo? Arts and Crafts? Activities? One on one visitations? Does your facility have volunteers that could come and visit with her and give her that one on one attention? DVD player and movies? Books on tape? Needle work- sewing, embroidery, cross stitch, knitting, crocheting, cooking classes? Puzzles, puzzle books....what has activities assessed her as far as things she likes to do? Pet therapy? A bird or something that she could keep in her room and take care of? (although animals can be nasty and the staff may end up having more problems) The only way to keep her off the bell is keep her out of her room and involved in something, however that does not make it any easier later in the evening and at night, and of course she may refuse...I agree that it needs to be care planned that she does it, and that you need to document all the interventions you've tried. Does she try to get up by herself? That's the scary part, that she may get up and fall then say you wouldn't answer her bell....ugh...sorry, but there's one in every facility. Sometimes no matter what you do it will not change, but keep trying!

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Specializes in Hospice, ONC, Tele, Med Surg, Endo/Output.

Attach a thumb tack to her call light--that will stop her.

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